As a baby boy grows inside his mother, he develops testicles. Early in his development, his testicles are in his belly. Normally, before he is born, his testicles move down into his scrotum, the sac that hangs below the penis. When one testicle does not move into the scrotum as it should, the baby has an undescended testicle. In rare cases, both testicles are undescended.
About 5 out of 100 baby boys are born with an undescended testicle.1 It is most common in babies who were born before their due date or who were very small at birth.
Doctors don't really know what causes an undescended testicle. This common condition runs in some families (can be inherited).
Most of the time, the testicle descends (drops) on its own by the time the baby is 3 months old. If your baby’s testicle hasn't dropped by the time he is 6 months of age, your doctor may suggest treatment.
An undescended testicle doesn't cause pain or other symptoms. The scrotum may look a little smoother or less developed on one side, or the side without a testicle may look smaller and flatter. You can't feel the testicle in the scrotum on the side where it hasn't descended.
At newborn and well-baby visits, your doctor will check your baby’s scrotum.
Some other conditions are closely related to undescended testicles, such as an ectopic or retractile testicle. In both of these conditions, the testicle is in an abnormal position in the groin or scrotum. Your doctor will take care to make the correct diagnosis so your child can get the right treatment.
Usually doctors recommend a wait-and-see approach for newborns. If the testicle hasn't dropped on its own within 6 months, your doctor may recommend surgery (orchiopexy or orchidopexy). Surgery is done when the baby is 9 to 15 months old. It is safe and effective and has few risks. Most babies recover quickly.
When babies have a testicle that can't be felt, doctors may do a different surgery that needs only a small cut (laparoscopy).
Another treatment is hormone therapy. It may cause the testicle to drop down into the scrotum. If it works, surgery isn't needed. But it doesn't always work, and it may cause side effects.
Treatment is important, because having an undescended testicle increases the risk of:
Learning about undescended testicles:
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- Elder JS (2007). Disorders and anomalies of the scrotal contents. In RM Kliegman et al., eds., Nelson Textbook of Pediatrics, 18th ed., pp. 2260–2265. Philadelphia: Saunders Elsevier.
Other Works Consulted
- Pettersson A, et al. (2007). Age at surgery for undescended testis and risk of testicular cancer. New England Journal of Medicine, 356(18): 1835–1841.
- Schneck FX, Bellinger MF (2007). Abnormalities of the testes and scrotum and their surgical management. In AJ Wein, ed., Campbell-Walsh Urology, 9th ed., vol. 4, pp. 3761–3798. Philadelphia: Saunders Elsevier.
- Siegel NJ (2003). Cryptorchidism section of Kidney and urinary tract. In CD Rudolph et al., eds., Rudolph's Pediatrics, 21st ed., pp. 1740–1742. New York: McGraw-Hill.
- Walsh TJ, et al. (2007). Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. Journal of Urology, 178(4, Part 1): 1440–1446.
- Zeitler PS, et al. (2011). Cryptorchidism section of Endocrine disorders. In WW Hay Jr et al., eds., Current Diagnosis and Treatment: Pediatrics, 20th ed., pp. 973–974. New York: McGraw-Hill.
|Primary Medical Reviewer||John Pope, MD - Pediatrics|
|Specialist Medical Reviewer||Peter Anderson, MD, FRCS(C) - Pediatric Urology|
|Last Revised||April 1, 2011|
Last Revised: April 1, 2011
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